Chłoniak nieziarniczy
Diagnostyka i diagnoza

Chłoniak nieziarniczy (NHL) stanowi heterogeniczną grupę nowotworów złośliwych układu limfatycznego, wywodzących się z limfocytów B, T lub komórek NK. Diagnostyka opiera się na wieloetapowym procesie, którego podstawą jest biopsja wycinająca powiększonego węzła chłonnego, umożliwiająca dokładną ocenę histopatologiczną i immunofenotypową, niezbędną do określenia podtypu chłoniaka. Badania laboratoryjne, w tym morfologia krwi, poziom dehydrogenazy mleczanowej (LDH) oraz testy serologiczne w kierunku infekcji wirusowych (HIV, HBV, HCV), dostarczają informacji o stanie ogólnym pacjenta i mogą wskazywać na obecność choroby. Obrazowanie, takie jak tomografia komputerowa (CT), pozytonowa tomografia emisyjna (PET-CT), rezonans magnetyczny (MRI) oraz ultrasonografia, pozwala na ocenę lokalizacji, rozległości zmian oraz zaawansowania choroby, w tym zajęcia narządów pozalimfatycznych i ośrodkowego układu nerwowego.

  1. Diagnostyka chłoniaka nieziarniczego
    1. Badanie fizykalne i wywiad lekarski
    2. Biopsja – podstawowe badanie diagnostyczne
    3. Badania laboratoryjne
    4. Badania obrazowe
    5. Dodatkowe badania diagnostyczne
    6. Badania molekularne i immunofenotypowanie
  2. Ocena zaawansowania chłoniaka nieziarniczego
    1. Klasyfikacja Ann Arbor-Lugano
    2. Ocena stopnia agresywności chłoniaka
    3. Indeksy prognostyczne
  3. Znaczenie prawidłowej diagnostyki
  4. Perspektywy i postępy w diagnostyce
  5. Podsumowanie
    1. Kolejne rozdziały

Diagnostyka chłoniaka nieziarniczego

Chłoniak nieziarniczy (NHL) to heterogeniczna grupa nowotworów złośliwych układu limfatycznego, wywodzących się z limfocytów B, T lub komórek NK. Prawidłowa diagnoza ma kluczowe znaczenie dla określenia optymalnego planu leczenia, ponieważ różne podtypy chłoniaka nieziarniczego wymagają odmiennego podejścia terapeutycznego. Proces diagnostyczny obejmuje wiele etapów i metod badawczych, które pozwalają nie tylko na potwierdzenie diagnozy, ale także na określenie podtypu i stadium zaawansowania choroby.123

Badanie fizykalne i wywiad lekarski

Proces diagnostyczny najczęściej rozpoczyna się od dokładnego badania fizykalnego i wywiadu medycznego. Lekarz przeprowadza wywiad dotyczący historii zdrowotnej pacjenta, objawów, czynników ryzyka oraz historii chorób w rodzinie. Podczas badania fizykalnego lekarz zwraca szczególną uwagę na powiększone węzły chłonne w okolicach szyi, pach i pachwin, a także bada jamę brzuszną i klatkę piersiową w poszukiwaniu powiększonych narządów lub gromadzenia się płynu.123

Do najczęstszych objawów chłoniaka nieziarniczego należą bezbolesne powiększenie węzłów chłonnych, gorączka, nocne poty, niewyjaśniona utrata masy ciała oraz uczucie zmęczenia. Obecność tych objawów, szczególnie utrzymujących się przez dłuższy czas, może sugerować konieczność dalszej diagnostyki w kierunku chłoniaka.12

Biopsja – podstawowe badanie diagnostyczne

Biopsja jest złotym standardem w diagnostyce chłoniaka nieziarniczego i jedynym badaniem, które może definitywnie potwierdzić diagnozę. Polega na pobraniu próbki tkanki do badania histopatologicznego, co umożliwia dokładną analizę komórek nowotworowych pod mikroskopem.1234

Wyróżnia się kilka typów biopsji stosowanych w diagnostyce chłoniaka nieziarniczego:

  • Biopsja wycinająca (ekscyzyjna) – polega na całkowitym usunięciu powiększonego węzła chłonnego. Jest to najczęściej stosowany i najbardziej wiarygodny rodzaj biopsji, ponieważ dostarcza wystarczająco dużo materiału do dokładnej analizy i pozwala na ocenę architektury węzła chłonnego.123
  • Biopsja nacinająca (incyzyjna) – polega na usunięciu tylko części powiększonego węzła chłonnego.1
  • Biopsja cienkoigłowa (FNA) lub biopsja gruboigłowa – polega na wprowadzeniu cienkiej igły przez skórę do powiększonego węzła chłonnego i pobraniu niewielkiej ilości tkanki. Ten rodzaj biopsji jest mniej inwazyjny, ale często nie dostarcza wystarczającej ilości materiału do postawienia jednoznacznej diagnozy, dlatego rzadziej stosuje się go w diagnostyce chłoniaka nieziarniczego.12

Pobrany materiał jest analizowany przez patomorfologa, najlepiej specjalizującego się w diagnostyce chorób układu krwiotwórczego (hematopatologa). Analiza histopatologiczna pozwala nie tylko na potwierdzenie obecności komórek nowotworowych, ale także na określenie dokładnego podtypu chłoniaka nieziarniczego, co ma kluczowe znaczenie dla planowania leczenia.123

Badania laboratoryjne

Chociaż badania krwi same w sobie nie mogą potwierdzić diagnozy chłoniaka nieziarniczego, dostarczają ważnych informacji o stanie zdrowia pacjenta i mogą wskazywać na obecność choroby. Do najczęściej wykonywanych badań laboratoryjnych należą:12

  • Morfologia krwi z rozmazem (CBC) – ocenia liczbę i jakość krwinek białych, czerwonych oraz płytek krwi. Może wykazać nieprawidłowości sugerujące obecność chłoniaka, takie jak podwyższona liczba białych krwinek czy anemia.12
  • Badania biochemiczne krwi – oceniają funkcjonowanie narządów, takich jak wątroba i nerki, oraz wykrywają potencjalne nieprawidłowości.12
  • Dehydrogenaza mleczanowa (LDH) – podwyższony poziom tego enzymu może wskazywać na obecność chłoniaka i jest używany jako marker prognostyczny.12
  • Badania w kierunku wirusów – wykrywają obecność infekcji wirusowych, takich jak HIV, wirus zapalenia wątroby typu B i C, które mogą być związane z rozwojem niektórych typów chłoniaka i wpływać na decyzje terapeutyczne.12

Badania obrazowe

Badania obrazowe odgrywają kluczową rolę w diagnostyce i ocenie zaawansowania chłoniaka nieziarniczego. Pozwalają określić lokalizację i rozmiar zmian nowotworowych oraz sprawdzić, czy choroba rozprzestrzeniła się na inne organy. Do najczęściej stosowanych badań obrazowych należą:12

  • Tomografia komputerowa (CT) – wykorzystuje promieniowanie rentgenowskie i komputer do tworzenia szczegółowych, trójwymiarowych obrazów przekrojowych ciała. Jest podstawowym badaniem pozwalającym ocenić wielkość i lokalizację powiększonych węzłów chłonnych oraz zajęcie narządów wewnętrznych.12
  • Pozytonowa tomografia emisyjna (PET) – wykorzystuje radioaktywną glukozę do uwidocznienia obszarów o zwiększonej aktywności metabolicznej, co pomaga w identyfikacji aktywnych komórek chłoniaka. Badanie PET jest szczególnie przydatne w ocenie odpowiedzi na leczenie.12
  • PET-CT – połączenie badania PET i CT dostarcza zarówno informacji metabolicznych, jak i anatomicznych, co zwiększa dokładność oceny zaawansowania choroby.12
  • Rezonans magnetyczny (MRI) – wykorzystuje pole magnetyczne i fale radiowe do tworzenia szczegółowych obrazów struktur ciała. Jest szczególnie przydatny w ocenie zajęcia ośrodkowego układu nerwowego.12
  • Ultrasonografia – wykorzystuje fale dźwiękowe do tworzenia obrazów struktur ciała. Jest pomocna w ocenie wielkości śledziony oraz powierzchownych węzłów chłonnych.12
  • Zdjęcie rentgenowskie klatki piersiowej – pozwala na wstępną ocenę powiększenia węzłów chłonnych w klatce piersiowej oraz wykrycie ewentualnych zmian w płucach.12

Dodatkowe badania diagnostyczne

W zależności od podejrzewanego podtypu chłoniaka i objawów klinicznych, lekarz może zalecić wykonanie dodatkowych badań:12

  • Biopsja szpiku kostnego – pobiera się próbkę szpiku kostnego, najczęściej z tylnej części kości biodrowej, aby sprawdzić, czy chłoniak rozprzestrzenił się do szpiku kostnego. Badanie to obejmuje aspirację (pobranie płynnej części szpiku) oraz biopsję (pobranie fragmentu kości ze szpikiem).12
  • Nakłucie lędźwiowe (punkcja płynu mózgowo-rdzeniowego) – polega na pobraniu niewielkiej ilości płynu mózgowo-rdzeniowego z przestrzeni wokół rdzenia kręgowego. Badanie to wykonuje się, gdy istnieje podejrzenie zajęcia ośrodkowego układu nerwowego przez chłoniaka.123
  • Badania endoskopowe – w przypadku podejrzenia zajęcia przewodu pokarmowego przez chłoniaka, mogą być wykonane badania takie jak gastroskopia czy kolonoskopia.1

Badania molekularne i immunofenotypowanie

Nowoczesne metody diagnostyczne pozwalają na szczegółową charakterystykę komórek chłoniaka na poziomie molekularnym i genetycznym, co ma kluczowe znaczenie dla dokładnego określenia podtypu chłoniaka i wyboru optymalnego leczenia:123

  • Immunofenotypowanie – metoda pozwalająca na identyfikację specyficznych antygenów na powierzchni komórek chłoniaka. Może być przeprowadzana za pomocą immunohistochemii lub cytometrii przepływowej. Pomaga w określeniu dokładnego podtypu chłoniaka, co jest kluczowe dla planowania leczenia.123
  • Badania cytogenetyczne – analizują chromosomy komórek chłoniaka, ich liczbę, rozmiar, kształt i układ. Pozwalają na wykrycie specyficznych aberracji chromosomowych, które mogą być charakterystyczne dla określonych podtypów chłoniaka.12
  • Badania molekularne – analizują DNA i RNA komórek chłoniaka w poszukiwaniu specyficznych mutacji genetycznych, które mogą wpływać na przebieg choroby i odpowiedź na leczenie. Do tych badań należą m.in. FISH (fluorescencyjna hybrydyzacja in situ) oraz PCR (reakcja łańcuchowa polimerazy).12

Ocena zaawansowania chłoniaka nieziarniczego

Po potwierdzeniu diagnozy chłoniaka nieziarniczego, kolejnym ważnym krokiem jest określenie stadium zaawansowania choroby, co ma kluczowe znaczenie dla wyboru odpowiedniej strategii leczenia i rokowania.12

Klasyfikacja Ann Arbor-Lugano

Do oceny stopnia zaawansowania chłoniaka nieziarniczego najczęściej stosuje się klasyfikację Ann Arbor, zmodyfikowaną przez klasyfikację Lugano. System ten dzieli chłoniaka na cztery stadia w zależności od rozległości zajęcia tkanek:1234

  • Stadium I – zajęcie jednej grupy węzłów chłonnych lub jednego narządu pozalimfatycznego.
  • Stadium II – zajęcie dwóch lub więcej grup węzłów chłonnych po tej samej stronie przepony.
  • Stadium III – zajęcie węzłów chłonnych lub narządów po obu stronach przepony.
  • Stadium IV – rozsiany chłoniak z zajęciem jednego lub więcej narządów pozalimfatycznych, takich jak szpik kostny, wątroba czy płuca.

Dodatkowo do oznaczenia stadium dodaje się litery „A” lub „B” w zależności od obecności objawów ogólnych, takich jak gorączka, nocne poty czy utrata masy ciała (B), lub ich braku (A).12

Ocena stopnia agresywności chłoniaka

Oprócz stadium zaawansowania, ważnym elementem oceny chłoniaka nieziarniczego jest określenie jego stopnia agresywności (grade). Wyróżnia się dwa główne stopnie:123

  • Niskozłośliwy (indolentny) – chłoniak rośnie powoli, a objawy mogą nie występować przez wiele lat. Chociaż ten typ chłoniaka dobrze reaguje na leczenie, trudno jest go całkowicie wyleczyć i często jest leczony z założeniem kontroli choroby, a nie jej wyleczenia.
  • Wysokozłośliwy (agresywny) – chłoniak rośnie szybko i agresywnie. Mimo że nazwa może brzmieć alarmująco, ten typ chłoniaka często bardzo dobrze reaguje na leczenie i w wielu przypadkach może być całkowicie wyleczony.

Indeksy prognostyczne

W celu dokładniejszej oceny rokowania pacjentów z chłoniakiem nieziarniczym stosuje się różne indeksy prognostyczne, które uwzględniają czynniki ryzyka mające wpływ na przebieg choroby. Najczęściej stosowane to:123

Liczba obecnych czynników ryzyka określa kategorię ryzyka pacjenta, co pomaga w przewidywaniu odpowiedzi na leczenie i długoterminowego rokowania.1

Znaczenie prawidłowej diagnostyki

Precyzyjna i kompleksowa diagnostyka chłoniaka nieziarniczego ma fundamentalne znaczenie dla wyboru optymalnej strategii leczenia i osiągnięcia najlepszych możliwych wyników. Ze względu na dużą różnorodność podtypów chłoniaka nieziarniczego (ponad 60 różnych podtypów) i ich odmienne zachowanie kliniczne oraz odpowiedź na leczenie, dokładna diagnoza jest kluczowa.123

W niektórych przypadkach, zwłaszcza gdy diagnoza jest trudna lub niejednoznaczna, warto rozważyć konsultację w wyspecjalizowanym ośrodku hematologicznym lub uzyskanie drugiej opinii od doświadczonego hematolopatologa. Badania pokazują, że w 10-15% przypadków druga opinia może prowadzić do zmiany wstępnej diagnozy, co może istotnie wpłynąć na plan leczenia.123

Dzięki nowoczesnym metodom molekularnym i genetycznym, diagnostyka chłoniaka nieziarniczego staje się coraz bardziej precyzyjna, co pozwala na lepsze dostosowanie leczenia do specyficznych cech nowotworu danego pacjenta. Indywidualizacja leczenia oparta na dokładnej charakterystyce molekularnej chłoniaka stanowi obiecujący kierunek w onkologii i hematologii, oferując pacjentom lepsze wyniki leczenia i jakość życia.123

Perspektywy i postępy w diagnostyce

Diagnostyka chłoniaka nieziarniczego ulega ciągłemu rozwojowi dzięki postępom w dziedzinie genetyki, biologii molekularnej i obrazowania medycznego. Nowe technologie diagnostyczne pozwalają na coraz dokładniejszą klasyfikację podtypów chłoniaka, co prowadzi do bardziej spersonalizowanego podejścia do leczenia.12

Zaawansowane badania molekularne mają coraz większy wpływ na diagnozę i stratyfikację pacjentów z chłoniakiem. Chociaż technologie te są takie same dla wszystkich podtypów chłoniaka, dane potwierdzające ich rutynowe zastosowanie kliniczne są największe w przypadku chłoniaków B-komórkowych o wysokim stopniu złośliwości.1

Istnieje również rosnące zapotrzebowanie na nieinwazyjne metody monitorowania odpowiedzi na leczenie i wczesnego wykrywania nawrotów. Obiecujące w tym kontekście są badania oparte na analizie krążącego DNA nowotworowego (ctDNA) oraz zaawansowane techniki obrazowania, takie jak PET-CT z nowymi znacznikami.1

Lepsze zrozumienie biologii chłoniaka nieziarniczego na poziomie molekularnym prowadzi też do rozwoju nowych terapii celowanych i immunoterapii, które są dostosowane do specyficznych cech genetycznych i molekularnych nowotworu. W połączeniu z precyzyjną diagnostyką, te innowacyjne metody leczenia oferują pacjentom z chłoniakiem nieziarniczym lepsze rokowanie i jakość życia.12

Podsumowanie

Diagnostyka chłoniaka nieziarniczego to złożony proces wymagający współpracy wielu specjalistów, w tym hematologów, patologów, radiologów i specjalistów medycyny molekularnej. Kluczowym elementem procesu diagnostycznego jest biopsja, najlepiej wycinająca całego węzła chłonnego, która pozwala na dokładną ocenę histopatologiczną i określenie podtypu chłoniaka.12

Badania obrazowe, laboratoryjne oraz zaawansowane techniki molekularne i genetyczne uzupełniają diagnozę, pozwalając na określenie stopnia zaawansowania choroby i opracowanie optymalnego planu leczenia. Dzięki ciągłemu rozwojowi metod diagnostycznych, pacjenci z chłoniakiem nieziarniczym mają dostęp do coraz bardziej precyzyjnej diagnozy i spersonalizowanego leczenia, co przekłada się na lepsze wyniki terapeutyczne.12

Warto podkreślić, że wczesna i dokładna diagnoza chłoniaka nieziarniczego ma kluczowe znaczenie dla powodzenia leczenia. Dlatego osoby, które obserwują u siebie niepokojące objawy, takie jak utrzymujące się powiększenie węzłów chłonnych, niewyjaśniona gorączka, nocne poty czy utrata masy ciała, powinny jak najszybciej skonsultować się z lekarzem.12

Kolejne rozdziały

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Non-Hodgkin’s lymphoma – Symptoms, diagnosis and treatment | BMJ Best Practice
    https://bestpractice.bmj.com/topics/en-gb/312
    Non-Hodgkin’s lymphomas (NHLs) are a heterogeneous group of malignancies of the lymphoid system. […] Diagnosis is confirmed by histopathology (e.g., biopsy of lymph node or extranodal sites) and immunophenotyping. […] Diagnostic investigations include FBC with differential, peripheral blood smear, comprehensive metabolic panel (including liver function tests [LFTs]), serum lactate dehydrogenase (LDH), uric acid, lymph node biopsy, biopsy (extranodal sites e.g., brain, skin), bone marrow biopsy and aspirate, immunohistochemistry, flow cytometry, and fluorodeoxyglucose (FDG)-PET/CT scan. […] Investigations to consider include core needle biopsy, fine-needle aspiration (FNA) biopsy, genetic testing, hepatitis B and C serology, HIV testing, Epstein-Barr virus (EBV) testing, human T-cell lymphotropic virus (HTLV) testing, MRI (brain, spine), ultrasound (breast, axilla), lumbar puncture, endoscopy and colonoscopy, serum protein electrophoresis with immunofixation, quantitative immunoglobulins, serum beta-2 microglobulin, Helicobacter pylori testing, multigated acquisition (MUGA) scan, and echocardiography.
  • #1 Diagnosing Non-Hodgkin Lymphoma | NYU Langone Health
    https://nyulangone.org/conditions/non-hodgkin-lymphoma/diagnosis
    Diagnosing Non-Hodgkin Lymphoma […] After conducting a physical exam, which includes feeling your lymph nodes and asking about your symptoms and medical history, your doctor may perform several tests to determine whether non-Hodgkin lymphoma is present and, if so, how fast it is growing. As part of the diagnosis, your doctor can also determine how far the disease has spread, how well the disease may respond to therapy, and how likely it is to come back after treatment. […] Making an accurate diagnosis is a critical part of determining the best treatment for you. […] Blood tests can help your doctors detect the presence of some of the telltale signs of non-Hodgkin lymphoma. […] To diagnose non-Hodgkin lymphoma, NYU Langone doctors perform a biopsy, in which they take a tissue sample from a swollen lymph node found during the physical exam or with imaging tests, such as CT, PET, or MRI, which doctors often use when diagnosing cancer, and evaluate it under a microscope.
  • #1 Non-Hodgkin Lymphoma Diagnosis – Lymphoma Research Foundation
    https://www.lymphoma.org/understanding-lymphoma/aboutlymphoma/nhl/nhldiagnosis/
    Common signs and symptoms of NHL include swelling of the lymph nodes (which is often but not always painless), fever, night sweats, unexplained weight loss, and lack of energy. […] In order for a physician to make an accurate non-Hodgkin lymphoma diagnosis, a patient is required to undergo a number of diagnostic tests. […] A biopsy of an affected lymph node or a sample of the tumor is the only way to make a definite diagnosis of NHL. […] A correct diagnosis is important so that appropriate treatments can be used to effectively treat the patients particular type of lymphoma. […] Further examinations will then be performed to determine how far the disease has spread (staging) and how well the patients body is functioning. […] The physician may use some or all of the following tests as well as the patients medical history to assess the course of treatment that has the best chance of rendering either a remission or cure. […] All of the information gained from these tests will help the patients healthcare team determine the best course of treatment.
  • #1 Non-Hodgkin lymphoma – Diagnosis and treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/non-hodgkins-lymphoma/diagnosis-treatment/drc-20375685
    Non-Hodgkin lymphoma diagnosis often begins with an exam that checks for swollen lymph nodes in the neck, underarms and groin. Tests include imaging tests and removing some cells for testing. The tests used to detect non-Hodgkin lymphoma may depend on the cancer’s location and your symptoms. […] Your healthcare professional may suggest a lymph node biopsy to look for cancer cells. A biopsy is a procedure to remove a sample of tissue for testing in a lab. A lymph node biopsy involves removing all or part of a lymph node. In the lab, tests may show whether you have non-Hodgkin lymphoma and, if so, which type. […] A lumbar puncture involves removing some of the fluid around the spinal cord. This procedure also is called a spinal tap. A healthcare professional might recommend this test if there’s concern that the lymphoma affects the fluid around the spinal cord.
  • #1 Non-Hodgkin Lymphoma: Diagnosis
    https://healthlibrary.reading.towerhealth.org/Library/DiseasesConditions/Pediatric/Allergy/34,BLymD1
    How is non-Hodgkin lymphoma diagnosed? If your health care provider thinks you may have non-Hodgkin lymphoma, you’ll need certain exams and tests to be sure. The process starts with your provider asking you questions. You’ll be asked about your health history, your symptoms, risk factors, and family history of disease. You will also have a physical exam. It will include looking for swollen lymph nodes and signs of infection. […] Based on the findings, your provider may decide you need a biopsy to check for cancer. […] A biopsy is done by taking out a tiny piece of tissue (called a sample) so it can be tested for cancer cells. A biopsy is the only sure way to know if you have non-Hodgkin lymphoma. […] For a biopsy, the provider removes a tissue sample from the swollen lymph nodes. The sample is sent to a lab. There, a provider called a pathologist tests it for cancer cells. There are a few ways a biopsy can be done to look for non-Hodgkin lymphoma.
  • #1 Non-Hodgkin Lymphoma: Diagnosis
    https://healthlibrary.reading.towerhealth.org/Library/DiseasesConditions/Pediatric/Allergy/34,BLymD1
    This type is the most common biopsy used to diagnose non-Hodgkin lymphoma. For an excisional biopsy, a whole lymph node is taken out through a small cut made in your skin. If only part of the lymph node is removed, it’s called an incisional biopsy. […] This kind of biopsy almost always gives the pathologist enough tissue to make a diagnosis. […] For this type of biopsy, a thin, hollow needle is put through your skin and into the swollen lymph node. Then a syringe is used to pull some tissue into the needle. […] Needle biopsies mean no surgery. But they don’t always remove enough tissue for a definite diagnosis. Because of this, they aren’t often used to diagnose non-Hodgkin lymphoma. Still, they can help to check for other problems, such as infection in the lymph nodes. […] A pathologist can often see if a person has non-Hodgkin lymphoma by using a microscope to look at the cells in the biopsy sample. But in many cases, other types of lab tests may be needed. The tests help to: Make sure the diagnosis is correct.
  • #1 Non-Hodgkin Lymphoma: Diagnosis
    https://healthlibrary.umcno.org/Library/DiseasesConditions/Adult/Gynecological/34,BLymD1
    The different types of biopsies include: Excisional or incisional biopsy. This type is the most common biopsy used to diagnose non-Hodgkin lymphoma. For an excisional biopsy, a whole lymph node is taken out through a small cut made in your skin. If only part of the lymph node is removed, it’s called an incisional biopsy. […] This kind of biopsy almost always gives the pathologist enough tissue to make a diagnosis. […] Fine needle aspiration (FNA) or core needle biopsy. For this type of biopsy, a thin, hollow needle is put through your skin and into the swollen lymph node. Then a syringe is used to pull some tissue into the needle. […] Needle biopsies mean no surgery. But they don’t always remove enough tissue for a definite diagnosis. Because of this, they aren’t often used to diagnose non-Hodgkin lymphoma. Still, they can help to check for other problems, such as infection in the lymph nodes.
  • #1 Non-Hodgkin Lymphoma Diagnosis – Lymphoma Research Foundation
    https://lymphoma.org/understanding-lymphoma/aboutlymphoma/nhl/nhldiagnosis/
    Common signs and symptoms of NHL include swelling of the lymph nodes (which is often but not always painless), fever, night sweats, unexplained weight loss, and lack of energy. […] In order for a physician to make an accurate non-Hodgkin lymphoma diagnosis, a patient is required to undergo a number of diagnostic tests. […] A biopsy of an affected lymph node or a sample of the tumor is the only way to make a definite diagnosis of NHL. […] A pathologist (doctor who specializes in diagnosing disease by looking at tumor tissue under the microscope) or a hematopathologist (physician who specializes in diagnosing diseases of the blood) who is experienced in diagnosing lymphoma should review the biopsy. […] This is because there are several different types of lymphoma, many of which are very uncommon, and special procedures and tests may be needed in order to make an accurate diagnosis.
  • #1 Lymphoma Blood Tests: What You Need To Know | MyLymphomaTeam
    https://www.mylymphomateam.com/resources/blood-tests-for-non-hodgkin-lymphoma-what-you-need-to-know
    Lymphoma is a blood cancer in which white blood cells called lymphocytes develop abnormally and crowd out healthy cells. Your doctor will need to perform a lymph node or bone marrow biopsy to diagnose lymphoma, but blood tests can still offer valuable information before, during, and after treatment. […] Although blood testing cant diagnose Hodgkin or non-Hodgkin lymphoma (NHL), it can help your health care team understand how lymphoma and its treatments are affecting you. […] Several types of blood tests are available for people with lymphoma. Each can reveal details about different aspects of your general health. […] These are some of the most common blood tests that your doctor may order to help monitor lymphoma and make decisions about your treatment options: Complete blood count, Tumor marker blood tests, Lactate dehydrogenase tests, Plasma viscosity tests, Antibody testing, Urea and electrolyte testing.
  • #1 Lymphoma Blood Tests: What You Need To Know | MyLymphomaTeam
    https://www.mylymphomateam.com/resources/blood-tests-for-non-hodgkin-lymphoma-what-you-need-to-know
    The most common type of blood test for lymphoma is a complete blood count (CBC), also known as a full blood count. […] A CBC can also tell doctors if you are anemic. This means that you dont have enough red blood cells in your bloodstream. Because these cells transport oxygen throughout your body, low levels can make you extremely tired. This is one key sign of NHL. […] Some subtypes of NHL cause abnormalities in the levels of certain substances (mostly proteins) in your bloodstream. […] Another common blood test for those diagnosed with NHL is a lactate dehydrogenase (LDH) test. This protein shows that cells are being destroyed or are dying. People diagnosed with NHL may have higher levels of LDH. […] This test is designed to determine how viscous (thick) your blood is. It can help your doctors monitor your lymphoma, particularly if you have been diagnosed with a type of NHL called lymphoplasmacytic lymphoma.
  • #1 Non-Hodgkin’s Lymphoma – Diagnosis and Treatment
    https://www.hcgoncology.com/types-of-cancers/non-hodgkins-lymphoma-diagnosis-and-treatment/
    This blood test for non-Hodgkin’s lymphoma assesses organ function and detects any abnormalities that may indicate lymphoma involvement. Elevated levels of certain enzymes or chemicals can be indicative of lymphoma-related changes. […] LDH levels are often elevated in individuals with lymphomas. Measuring LDH helps assess cell turnover and can aid in diagnosing and monitoring the progression of non-Hodgkin’s lymphoma. […] Imaging plays a vital role in a non-Hodgkins lymphoma diagnosis by assessing the extent and location of lymphoma. Different imaging modalities provide detailed insights into affected areas. […] A CT scan creates detailed cross-sectional images of the body, helping to visualize lymph nodes and other structures. As a diagnostic test for non-Hodgkin’s lymphoma, it aids in staging and determining the spread of non-Hodgkin’s lymphoma.
  • #1 Non-Hodgkin’s Lymphoma – Diagnosis and Treatment
    https://www.hcgoncology.com/types-of-cancers/non-hodgkins-lymphoma-diagnosis-and-treatment/
    Testing for hepatitis B and C is essential before starting treatment, as certain therapies may impact liver function. Co-infection with these viruses can also influence treatment choices. […] Testing for HIV is important due to the impact of compromised immunity on non-Hodgkin’s lymphoma development and treatment decisions. Managing co-existing conditions is integral to comprehensive care.
  • #1 Diagnosing Non-Hodgkin Lymphoma | NYU Langone Health
    https://nyulangone.org/conditions/non-hodgkin-lymphoma/diagnosis
    Our doctors may use a series of imaging tests to determine how far within the body non-Hodgkin lymphoma has spread. […] A CT scan uses X-rays and a computer to create three-dimensional, cross-sectional images of the body. […] Your doctor may use a PET scan to look for small non-Hodgkin lymphoma tumors and to determine how rapidly the cancer is growing. […] An MRI scan uses a magnetic field and radio waves to create computerized, three-dimensional images of structures in your body. […] An ultrasound, which uses sound waves to create images on a computer monitor, may be useful in determining the size of your spleen. […] After our doctors have completed the testing, they can determine what type of treatment is best for you.
  • #1 Lymphoma: Diagnosis and Treatment | AAFP
    https://www.aafp.org/pubs/afp/issues/2020/0101/p34.html
    Lymphoma is a group of malignant neoplasms of lymphocytes with more than 90 subtypes. It is traditionally classified broadly as non-Hodgkin or Hodgkin lymphoma. Approximately 82,000 new U.S. patients are diagnosed with lymphoma annually. […] An open lymph node biopsy is preferred for diagnosis. […] The diagnosis of lymphoma is made using an open lymph node biopsy, based off morphology, immunohistochemistry, and flow cytometry. […] Although fine-needle aspiration and core needle biopsy are often part of the initial evaluation of any adenopathy, neither will provide adequate tissue for the diagnosis of lymphoma because of the need to verify Hodgkin lymphoma via the presence of Reed-Sternberg cells. […] The Ann Arbor staging system was initially developed in 1971 for Hodgkin lymphoma, and was later adapted for non-Hodgkin lymphoma. The Lugano classification system further modified staging by incorporating positron emission tomography/computed tomography (PET-CT) results to determine the staging of the lymphoma.
  • #1 Diagnosis of non-Hodgkin lymphoma | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/non-hodgkin-lymphoma/diagnosis
    Blood chemistry tests measure certain chemicals in the blood. They show how well certain organs are working and can help find problems. Blood chemistry tests used to diagnose and stage NHL include the following. […] A chest x-ray is used to check for larger than normal lymph nodes in the chest. It is also used to see if NHL has spread to the lungs. […] A CT scan may be used to check for enlarged lymph nodes or a mass in the neck, chest, abdomen or pelvis. It also allows doctors to see if a tumour is pressing on any organs or large blood vessels, or if there is any disease in the brain or near the spinal cord. A CT scan may also be used to see if the cancer has spread to any organs, such as the lungs, liver or spleen. […] During a biopsy, the doctor removes tissues or cells from the body so they can be tested in a lab. A report from a pathologist will show whether or not cancer cells are found in the sample.
  • #1 Diagnosing Non-Hodgkin Lymphoma | NYU Langone Health
    https://nyulangone.org/conditions/non-hodgkin-lymphoma/diagnosis
    The tissue sample taken during a biopsy helps your doctor determine the presence of proteins or other substances on individual cancer cells. […] Doctors at NYU Langone prefer to remove one entire lymph node during a biopsy. […] If surgical biopsy is not possible because the swollen lymph node is too close to vital blood vessels or nerves that make it difficult to reach, your doctor may obtain a smaller tissue sample using a needle biopsy. […] Our doctors may use bone marrow aspiration and biopsy to determine if non-Hodgkin lymphoma has spread to the bone marrow, the soft spongy tissue that makes blood cells and is found in the center of bones throughout the body. […] Doctors may perform a lumbar puncture if they suspect you have a type of non-Hodgkin lymphoma that could spread to the cerebrospinal fluid, which surrounds the spine and brain.
  • #1 Non-Hodgkin Lymphoma Facts | Fred Hutchinson Cancer Center
    https://www.fredhutch.org/en/diseases/non-hodgkin-lymphoma/facts-resources.html
    After numbing the area so there is no pain, a physician uses a hollow needle to take a sample of marrow (bone marrow aspiration) and a small piece of bone (bone marrow biopsy). A pathologist checks these samples for signs of cancer. […] Your physician recommends other tests based on your NHL subtype and your signs and symptoms. For example, if you have a type of lymphoma that affects the digestive tract, you may need an endoscopy to check your esophagus, stomach or small intestine. You may need a colonoscopy to check your large intestine. If it seems like lymphoma is affecting your brain or spinal cord, you may need a lumbar puncture. […] There are more treatment options today than ever before to control NHL or put it into remission. […] Each subtype of NHL acts differently. Fred Hutch physicians who specialize in NHL have a deep knowledge of these subtypes, and they know which therapies to use and when to use them.
  • #1 Diagnosis of non-Hodgkin lymphoma | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/non-hodgkin-lymphoma/diagnosis
    A lumbar puncture (also called a spinal tap) removes a small amount of cerebrospinal fluid (CSF) from the space around the spine for examination under a microscope. The sample of CSF will show if NHL is in the brain and spinal cord (called the central nervous system, or CNS). […] Cytogenetics is the analysis of a cell’s chromosomes, including their number, size, shape and arrangement. Cytogenetic techniques show chromosomal abnormalities, which help doctors confirm the diagnosis and identify the type or subtype of NHL. […] Immunophenotyping is the study of proteins expressed by cells. It uses a very specific antigen-antibody reaction to identify proteins in tissues or cells. The fluorescent label and the pattern of proteins that are expressed allow doctors to identify the lymphoma cells so that they can diagnose the specific type or subtype of NHL.
  • #1 How We Diagnose Non-Hodgkin Lymphoma | Dana-Farber Cancer Institute
    https://www.dana-farber.org/cancer-care/types/non-hodgkin-lymphoma/diagnosis
    A pathologist then examines the lymph node tissue to look for the malignant cells. […] Immunophenotyping may be done on tissue that was removed to study the protein expressed by cells. This is used to diagnose the specific type of lymphoma by comparing the cancer cells to normal cells. […] Your doctor may conduct imaging studies, such as CT scans, X-rays, and PET scans. […] We have unique expertise in interpreting molecular and genomic tests and translating the data into an action plan. […] Your doctor may decide to run blood tests, including a blood chemistry study. […] Your doctor may check for lactate dehydrogenase (LDH), which can be used to predict prognosis and response to treatment. […] This procedure involves the removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist examines the bone marrow, blood, and bone to look for signs of cancer.
  • #1 Non-Hodgkin Lymphoma: Diagnosis – Stanford Medicine Children’s Health
    https://www.stanfordchildrens.org/en/topic/default?id=non-hodgkin-lymphoma-diagnosis-34-BLymD1
    A pathologist can often see if a person has non-Hodgkin lymphoma by using a microscope to look at the cells taken with the biopsy. But in many cases, other types of lab tests may be needed. […] This information helps the doctor decide on the best treatment plan for you. It also helps give a sense of your likely outcomes (prognosis). […] This test can help show different types of non-Hodgkin lymphoma. […] This is another test that can help tell the type of non-Hodgkin lymphoma. […] Some lymphomas have certain chromosome changes that help classify them. […] These tests may also be used to look for chromosome changes at a more detailed genetic or molecular level. […] FISH can find most chromosome changes that can be seen with standard cytogenetic tests. […] This is a very sensitive DNA test. It can also find some chromosome changes too small to be seen under a microscope. […] Your provider will also talk with you about other tests that may be needed if non-Hodgkin lymphoma is found.
  • #1 https://www.lls.org/lymphoma/non-hodgkin-lymphoma/diagnosis/nhl-staging
    https://www.lls.org/lymphoma/non-hodgkin-lymphoma/diagnosis/nhl-staging
    Once your doctor confirms an NHL diagnosis, he or she will determine the extent of your disease’s progression by staging. Staging helps your doctor predict the disease’s progression and develop a treatment plan. […] When all the diagnostic and staging tests are completed, the doctor will evaluate the information, identify the NHL subtype, determine which areas of the body are involved and begin to discuss treatment options with the patient.
  • #1
    https://www.nhs.uk/conditions/non-hodgkin-lymphoma/diagnosis/
    When the testing is complete, it should be possible to determine the stage of your lymphoma. „Staging” means scoring the cancer by how far it’s spread. […] Health professionals also add the letter „A” or „B” to your stage to indicate whether or not you have certain symptoms. […] Testing can also help health professionals decide the „grade” of the cancer. […] There are 2 main grades of non-Hodgkin lymphoma: low-grade or indolent non-Hodgkin lymphoma is where the cancer grows slowly, and you may not experience any symptoms for many years […] high-grade or aggressive non-Hodgkin lymphoma is where the cancer grows quickly and aggressively.
  • #1 Lymphoma: Diagnosis and Treatment | AAFP
    https://www.aafp.org/pubs/afp/issues/2020/0101/p34.html
    PET-CT is used for fluorodeoxyglucose-avid lymphoma subtypes, with symptoms alone being used for staging the remaining subtypes. […] The new staging system incorporates two symptom-based classifications: A (absence of symptoms) and B (presence of fever, weight loss, and night sweats) for Hodgkin lymphoma. […] A bone marrow biopsy is now recommended only for diffuse large B-cell lymphoma with a negative PET-CT result. […] The International Prognostic Index is used broadly for all subtypes of non-Hodgkin lymphoma, and the International Prognostic Score is used for Hodgkin lymphoma. […] Treatment of lymphoma consists of chemotherapy alone or in combination with radiotherapy. […] Treatment for non-Hodgkin lymphoma varies depending on the histology, but often uses treatments such as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) with or without rituximab (Rituxan; R-CHOP), a monoclonal antibody specific for CD20-positive B lymphocytes.
  • #1 Non-Hodgkin Lymphoma (NHL) Workup: Approach Considerations, Complete Blood Cell Count, Serum Chemistry Studies
    https://emedicine.medscape.com/article/203399-workup
    The workup in a patient with suspected non-Hodgkin lymphoma (NHL) should include the following: […] Excisional lymph node biopsy is required because lymphoma diagnosis relies heavily on careful assessment of altered nodal architecture accompanying lymphomatous infiltrates. […] In approximately 30-35% of adult patients with NHL, the extranodal sites are the primary presenting sites. The most common site is the GI tract. […] Staging is important in selecting a treatment and determining prognosis. CT scans of the neck, chest, abdomen, and pelvis, as well as bilateral bone marrow aspirate and biopsy, are necessary to stage the lymphoma. […] The Ann Arbor staging system is the most commonly used staging system for patients with NHL. This system divides NHL into 4 stages, as follows: […] In addition to staging, risk stratification is important in patients with NHL. Prospectively validated scoring systems that can be used to determine prognosis include the International Prognostic Index (IPI) for patients with diffuse large B-cell lymphoma and the Follicular Lymphoma International Prognostic Index, (FLIPI) for patients with follicular B-cell lymphomas. The greater the number of risk factors present, the higher the risk.
  • #1 Diagnosing Non-Hodgkin Lymphoma | Hematologists at Compass Oncology
    https://www.compassoncology.com/non-hodgkin-lymphoma/diagnosis
    To confirm a diagnosis of non-Hodgkin lymphoma, the hematologist will perform an exam, discuss your family history, and request tests to determine if non-Hodgkin lymphoma is present. […] The tests may include: […] Imaging tests. These tests include CT, MRI, and/or a PET scan. They are done to determine where the cancer is growing and if it has spread to other areas of the body. […] If the initial tests show signs of cancer, a biopsy is necessary. This procedure will determine if cancer is present. […] Excision or incisional biopsy. This is the most common type of biopsy because it will remove an entire lymph node (excisional) or a small portion of a larger tumor (incisional). A pathologist evaluates the samples under a microscope to determine if cancer cells are present. […] If non-Hodgkin lymphoma is confirmed from the biopsy, additional information will be available, including the subtype. There are over 60 subtypes of non-Hodgkin lymphoma, and understanding the specific type is critical for selecting the treatments that will work best. […] The stage of non-Hodgkin lymphoma will also be determined after a review of the biopsy results by the hematologist/oncologist. The extent of the cancer impacts the timing of treatments and the order in which they are given.
  • #1 How We Diagnose Non-Hodgkin Lymphoma | Dana-Farber Cancer Institute
    https://www.dana-farber.org/cancer-care/types/non-hodgkin-lymphoma/diagnosis
    Accurate diagnosis of your non-Hodgkin lymphoma subtype is crucial in determining the proper course of treatment, so it is important to be seen at or consult with a large lymphoma treatment center like ours, which diagnoses and cares for many patients with all forms of this kind of cancer. […] Data from our program shows that in 10 to 15 percent cases, a second opinion from Dana-Farber renders a different diagnosis from what was given by a referring doctor. […] We use a variety of highly specialized tests including genetic and molecular profiling to distinguish between the different subtypes. This is crucial, since even within the same diagnosis, the specific mutation „profile” of a cancer can predict very different outcomes. […] A biopsy of involved tissue or lymph nodes is essential to make a diagnosis.
  • #1 Diagnosis – Non-Hodgkin’s Lymphoma: Diagnosis and Management – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK385274/
    Clinical question: Is core biopsy an acceptable alternative to excision biopsy for the accurate diagnosis of suspected non-Hodgkin’s lymphoma at first presentation? […] Consider an excision biopsy as the first diagnostic procedure for people with suspected non-Hodgkin’s lymphoma at first presentation. […] Genetic and molecular testing has provided important insights into lymphoma biology. When applied to many lymphoma subtypes they have also demonstrated that the diagnosis and subclassification of lymphomas is more accurate when compared with traditional diagnostic methods such as standard microscopy and immunohistochemistry. […] The main problem is that most lymphoma diagnostic technologies are in a phase of rapid change. Data on these newer technologies is limited. […] The GC considered accurate classification of non Hodgkin’s lymphoma (NHL) to be the most important outcome when drafting the recommendations because treatment is crucially dependent on this.
  • #1 Diagnosis – Non-Hodgkin’s Lymphoma: Diagnosis and Management – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK385274/
    Advanced molecular diagnostics will have a major impact on the diagnosis and stratification of all patients with lymphoma. Although the technologies are the same across lymphoma subtypes the data supporting its routine clinical application is greatest in high grade B-cell lymphomas. […] The GC considered overall survival (OS) to be the critical outcome when drafting the recommendations as OS and progression free survival (PFS) are closely aligned in diffuse large B cell lymphoma (DLBCL) with only a small number of relapsing patients being cured by salvage therapy. […] The GC acknowledged that there would be an impact on surgical resources and uptake would be dependent on availability of surgical services.
  • #1 Lymphoma: Diagnosis and Treatment | AAFP
    https://www.aafp.org/pubs/afp/issues/2020/0101/p34.html
    Patients who have achieved remission need routine surveillance to monitor for complications and relapse, as well as age-appropriate screenings recommended by the U.S. Preventive Services Task Force. […] If a patient is asymptomatic, routine surveillance imaging does not improve outcomes or provide a clinical benefit. […] Surveillance imaging should be used in patients who have reported symptoms or who are at high risk of relapse in a place that would not be easily examined, and who would be candidates for treatment.
  • #1 Non-Hodgkin Lymphoma Diagnosis | MD Anderson Cancer Center
    https://www.mdanderson.org/cancer-types/non-hodgkin-lymphoma/non-hodgkin-lymphoma-diagnosis.html
    Immunophenotyping: Cells from a lymph node, blood or bone marrow are examined with a microscope to determine what type of non-Hodgkin lymphoma cells are present. […] If you are diagnosed with non-Hodgkin lymphoma, your doctor will determine the stage (or extent) of the disease. Staging is a way of classifying how much disease is in the body and where it has spread when it is diagnosed. This information helps your doctor decide on the best type of treatment. Once the staging classification is determined, it stays the same even if treatment is successful or the cancer spreads.
  • #1 Diagnosis – Non-Hodgkin’s Lymphoma: Diagnosis and Management – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK385274/
    The GC agreed that the benefits of an accurate lymphoma diagnosis outweighed the potential harms because it will ensure the patient enters the correct treatment pathway, but the GC balanced the benefits and harms of the recommendations by allowing for factors specific to an individual patient to guide the choice of diagnostic procedure. […] The GC noted that inadequate sample quality is a frequently occurring problem and presents a major challenge for diagnostic pathologists in confidently diagnosing suspected lymphoma. […] The GC estimated that the recommendations will increase the rate of excision biopsy and the associated costs, but this will be balanced by the decrease in cost associated with fewer diagnostic and non-diagnostic core biopsies and by the reduction in downstream costs associated with more accurate diagnoses.
  • #1 Non-Hodgkin Lymphoma Detection & Diagnosis
    https://www.oregoncancer.com/lymphoma/non-hodgkins-lymphoma/diagnosis
    As with most other cancers, early detection is the main key to the successful treatment of non-Hodgkin lymphoma (NHL). However, because there are currently no recommended screening tests, its more important than ever to pay attention to possible signs and symptoms associated with the disease. […] If you have swollen lymph nodes or another symptom that suggests non-Hodgkins lymphoma, your doctor will try to find out whats causing the problem. Your doctor will first ask about your personal and family medical history. He or she will also perform a physical examination, focusing specifically on your lymph nodes, liver, and spleen. If there are signs of an infection, you may be prescribed an antibiotic to see if that relieves the swelling. If not, and your doctor suspects lymphoma, other tests will be recommended.
  • #2 Non-Hodgkin Lymphoma – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK559328/
    Non-Hodgkin lymphoma is a group of malignant neoplasms originating from lymphoid tissues, mainly the lymph nodes. […] This activity describes the evaluation and management of non-Hodgkin Lymphoma and explains the interprofessional team’s role in evaluating and treating patients with this condition. […] Assess the evaluation of non-Hodgkin lymphoma. […] NHL comprises various subtypes, each with different epidemiologies, etiologies, immunophenotypic, genetic, clinical features, and response to therapy. […] The treatment of NHL varies greatly, depending on tumor stage, grade, type of lymphoma, and various patient factors (eg, symptoms, age, performance status). […] Up to two-thirds of patients present with peripheral lymphadenopathy. […] Patients may even present with features of acute perforation and gastrointestinal bleeding and, at times, with features of malabsorption syndrome.
  • #2
    https://www.nhs.uk/conditions/non-hodgkin-lymphoma/diagnosis/
    If you see your GP because you’re concerned about symptoms of non-Hodgkin lymphoma, they’ll ask about your health and may carry out a simple physical examination. […] If you’re referred to hospital, a biopsy will usually be carried out, as this is the only way to confirm a diagnosis of non-Hodgkin lymphoma. […] A pathologist (an expert in the study of diseased tissue) will then check the tissue sample for the presence of cancerous cells. […] If they find cancerous cells, they can also identify exactly which type of non-Hodgkin lymphoma you have, which is important for planning your treatment. […] If a biopsy confirms a diagnosis of non-Hodgkin lymphoma, further testing will be required to check how far the lymphoma has spread. […] This allows a doctor to diagnose the stage of your lymphoma.
  • #2 Non-Hodgkin Lymphoma Diagnosis – Lymphoma Research Foundation
    https://lymphoma.org/understanding-lymphoma/aboutlymphoma/nhl/nhldiagnosis/
    Common signs and symptoms of NHL include swelling of the lymph nodes (which is often but not always painless), fever, night sweats, unexplained weight loss, and lack of energy. […] In order for a physician to make an accurate non-Hodgkin lymphoma diagnosis, a patient is required to undergo a number of diagnostic tests. […] A biopsy of an affected lymph node or a sample of the tumor is the only way to make a definite diagnosis of NHL. […] A pathologist (doctor who specializes in diagnosing disease by looking at tumor tissue under the microscope) or a hematopathologist (physician who specializes in diagnosing diseases of the blood) who is experienced in diagnosing lymphoma should review the biopsy. […] This is because there are several different types of lymphoma, many of which are very uncommon, and special procedures and tests may be needed in order to make an accurate diagnosis.
  • #2 Non-Hodgkin Lymphoma: Diagnosis
    https://healthlibrary.reading.towerhealth.org/Library/DiseasesConditions/Pediatric/Allergy/34,BLymD1
    This type is the most common biopsy used to diagnose non-Hodgkin lymphoma. For an excisional biopsy, a whole lymph node is taken out through a small cut made in your skin. If only part of the lymph node is removed, it’s called an incisional biopsy. […] This kind of biopsy almost always gives the pathologist enough tissue to make a diagnosis. […] For this type of biopsy, a thin, hollow needle is put through your skin and into the swollen lymph node. Then a syringe is used to pull some tissue into the needle. […] Needle biopsies mean no surgery. But they don’t always remove enough tissue for a definite diagnosis. Because of this, they aren’t often used to diagnose non-Hodgkin lymphoma. Still, they can help to check for other problems, such as infection in the lymph nodes. […] A pathologist can often see if a person has non-Hodgkin lymphoma by using a microscope to look at the cells in the biopsy sample. But in many cases, other types of lab tests may be needed. The tests help to: Make sure the diagnosis is correct.
  • #2 Non-Hodgkin Lymphoma: Diagnosis
    https://healthlibrary.methodisthealthsystem.org/Library/DiseasesConditions/Adult/Skin/34,BLymD1
    How is non-Hodgkin lymphoma diagnosed? If your health care provider thinks you may have non-Hodgkin lymphoma, you’ll need certain exams and tests to be sure. The process starts with your provider asking you questions. You’ll be asked about your health history, your symptoms, risk factors, and family history of disease. You will also have a physical exam. It will include looking for swollen lymph nodes and signs of infection. […] Based on the findings, your provider may decide you need a biopsy to check for cancer. […] A biopsy is the only sure way to know if you have non-Hodgkin lymphoma. […] This kind of biopsy almost always gives the pathologist enough tissue to make a diagnosis. […] Needle biopsies mean no surgery. But they don’t always remove enough tissue for a definite diagnosis. Because of this, they aren’t often used to diagnose non-Hodgkin lymphoma.
  • #2 How We Diagnose Non-Hodgkin Lymphoma | Dana-Farber Cancer Institute
    https://www.dana-farber.org/cancer-care/types/non-hodgkin-lymphoma/diagnosis
    Accurate diagnosis of your non-Hodgkin lymphoma subtype is crucial in determining the proper course of treatment, so it is important to be seen at or consult with a large lymphoma treatment center like ours, which diagnoses and cares for many patients with all forms of this kind of cancer. […] Data from our program shows that in 10 to 15 percent cases, a second opinion from Dana-Farber renders a different diagnosis from what was given by a referring doctor. […] We use a variety of highly specialized tests including genetic and molecular profiling to distinguish between the different subtypes. This is crucial, since even within the same diagnosis, the specific mutation „profile” of a cancer can predict very different outcomes. […] A biopsy of involved tissue or lymph nodes is essential to make a diagnosis.
  • #2 Diagnosis of non-Hodgkin lymphoma | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/non-hodgkin-lymphoma/diagnosis
    Diagnosis is the process of finding out the cause of a health problem. Diagnosing non-Hodgkin lymphoma (NHL) usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and may do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for NHL or other health problems. […] The following tests are usually used to rule out or diagnose NHL. Many of the tests that are used to diagnose cancer are also used to find out the stage (how far the cancer has spread). Your doctor may also order other tests to check your general health and to help plan your treatment. […] A complete blood count (CBC) measures the number and quality of white blood cells, red blood cells and platelets. A CBC is done to help rule out infection, assess how well the blood-forming organs (such as the bone marrow or spleen) are working, provide a baseline for future blood counts taken during and after treatment, and see if lymphoma cells are in the blood.
  • #2 How We Diagnose Non-Hodgkin Lymphoma | Dana-Farber Cancer Institute
    https://www.dana-farber.org/cancer-care/types/non-hodgkin-lymphoma/diagnosis
    A pathologist then examines the lymph node tissue to look for the malignant cells. […] Immunophenotyping may be done on tissue that was removed to study the protein expressed by cells. This is used to diagnose the specific type of lymphoma by comparing the cancer cells to normal cells. […] Your doctor may conduct imaging studies, such as CT scans, X-rays, and PET scans. […] We have unique expertise in interpreting molecular and genomic tests and translating the data into an action plan. […] Your doctor may decide to run blood tests, including a blood chemistry study. […] Your doctor may check for lactate dehydrogenase (LDH), which can be used to predict prognosis and response to treatment. […] This procedure involves the removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist examines the bone marrow, blood, and bone to look for signs of cancer.
  • #2 Non-Hodgkin Lymphomas – Hematology and Oncology – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/hematology-and-oncology/lymphomas/non-hodgkin-lymphomas
    Immunophenotyping studies (using immunohistochemistry or flow cytometry) to determine the cell of origin are of great value in identifying specific subtypes and helping define prognosis and management. […] Once the diagnosis of lymphoma is made, staging tests are done. […] A combined fluorodeoxyglucose (FDG)-PET/CT scan of the chest, abdomen, and pelvis is recommended. […] Unilateral bone marrow aspiration and biopsy is often done in patients with non-Hodgkin lymphoma. […] Patients with non-Hodgkin lymphoma are initially screened for HIV and hepatitis B and C viruses. […] After diagnosis, stage is determined to guide therapy. […] The commonly used Lugano staging system incorporates symptoms, physical examination findings, results of imaging tests, and bone marrow biopsy in selected cases.
  • #2 Diagnosis of non-Hodgkin lymphoma | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/non-hodgkin-lymphoma/diagnosis
    Blood chemistry tests measure certain chemicals in the blood. They show how well certain organs are working and can help find problems. Blood chemistry tests used to diagnose and stage NHL include the following. […] A chest x-ray is used to check for larger than normal lymph nodes in the chest. It is also used to see if NHL has spread to the lungs. […] A CT scan may be used to check for enlarged lymph nodes or a mass in the neck, chest, abdomen or pelvis. It also allows doctors to see if a tumour is pressing on any organs or large blood vessels, or if there is any disease in the brain or near the spinal cord. A CT scan may also be used to see if the cancer has spread to any organs, such as the lungs, liver or spleen. […] During a biopsy, the doctor removes tissues or cells from the body so they can be tested in a lab. A report from a pathologist will show whether or not cancer cells are found in the sample.
  • #2 Non-Hodgkin’s Lymphoma – Diagnosis and Treatment
    https://www.hcgoncology.com/types-of-cancers/non-hodgkins-lymphoma-diagnosis-and-treatment/
    Positron Emission Tomography (PET) scans use a radioactive tracer to highlight areas with increased metabolic activity, aiding in identifying active lymphoma cells and assessing response to treatment. […] Ultrasound imaging is useful for evaluating superficial lymph nodes and organs. It helps in a non-Hodgkins lymphoma diagnosis by identifying abnormalities and guiding the biopsy process. […] A lymph node biopsy involves the removal of a small tissue sample for examination. As a confirmatory test for non-Hodgkins lymphoma diagnosis, it helps identify lymphoma cells, determine the subtype, and guide treatment decisions. […] Immunophenotyping analyzes cell surface proteins to categorize lymphoma cells accurately. This information is crucial for determining the specific type of non-Hodgkin’s lymphoma and planning targeted therapies.
  • #2 Lymphoma: Diagnosis and Treatment | AAFP
    https://www.aafp.org/pubs/afp/issues/2020/0101/p34.html
    PET-CT is used for fluorodeoxyglucose-avid lymphoma subtypes, with symptoms alone being used for staging the remaining subtypes. […] The new staging system incorporates two symptom-based classifications: A (absence of symptoms) and B (presence of fever, weight loss, and night sweats) for Hodgkin lymphoma. […] A bone marrow biopsy is now recommended only for diffuse large B-cell lymphoma with a negative PET-CT result. […] The International Prognostic Index is used broadly for all subtypes of non-Hodgkin lymphoma, and the International Prognostic Score is used for Hodgkin lymphoma. […] Treatment of lymphoma consists of chemotherapy alone or in combination with radiotherapy. […] Treatment for non-Hodgkin lymphoma varies depending on the histology, but often uses treatments such as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) with or without rituximab (Rituxan; R-CHOP), a monoclonal antibody specific for CD20-positive B lymphocytes.
  • #2 Diagnosis – Non-Hodgkin lymphoma – Cancer Institute | Northwell Health
    https://cancer.northwell.edu/cancer-care/non-hodgkin-lymphoma/diagnosis
    Chest X-rays: X-rays help our doctors look for tumors in the chest and lungs, or for other evidence of infection. CT or CAT scan (computerized axial tomography): More detailed than an X-ray, this procedure uses a combination of X-rays and computer technology to produce precise and accurate internal imagery. MRI (magnetic resonance imaging): A powerful magnet, radio waves and specialized computer imaging combine to create highly detailed pictures of areas inside the body.
  • #2 Non-Hodgkin Lymphoma | Symptoms, Diagnosis & Treatment
    https://www.cincinnatichildrens.org/health/n/non-hodgkin-lymphoma
    Non-Hodgkin lymphoma (NHL) is a type of cancer. It starts in a cell called a lymphocyte. […] The diagnosis of NHL is made by biopsy. This is a surgery that removes part or all of the abnormal lymph node. Pathologists examine the lymph node under a microscope to look for cancerous cells. […] Doctors also do tests to determine the extent of disease and to see if it has spread to other parts of the body. These tests can include: […] A chest X-ray to see if there are enlarged lymph nodes in the chest. […] A CT scan to check for lymphoma in the neck, chest, abdomen or pelvis. […] A PET scan can see if the disease has spread to the liver, bones, bone marrow or spleen. […] A spinal tap (also called a lumbar puncture) is sometimes done to find out if the NHL has spread to the fluid that surrounds the brain and spinal cord. […] A bone marrow biopsy, if doctors are concerned that the lymphoma has spread to the bone marrow.
  • #2 Diagnosing Non-Hodgkin Lymphoma | NYU Langone Health
    https://nyulangone.org/conditions/non-hodgkin-lymphoma/diagnosis
    The tissue sample taken during a biopsy helps your doctor determine the presence of proteins or other substances on individual cancer cells. […] Doctors at NYU Langone prefer to remove one entire lymph node during a biopsy. […] If surgical biopsy is not possible because the swollen lymph node is too close to vital blood vessels or nerves that make it difficult to reach, your doctor may obtain a smaller tissue sample using a needle biopsy. […] Our doctors may use bone marrow aspiration and biopsy to determine if non-Hodgkin lymphoma has spread to the bone marrow, the soft spongy tissue that makes blood cells and is found in the center of bones throughout the body. […] Doctors may perform a lumbar puncture if they suspect you have a type of non-Hodgkin lymphoma that could spread to the cerebrospinal fluid, which surrounds the spine and brain.
  • #2 Non-Hodgkin lymphoma diagnosis – Leukaemia Foundation
    https://www.leukaemia.org.au/blood-cancer/types-of-blood-cancer/lymphoma/non-hodgkin-lymphoma/diagnosis/
    PET scanning (positron emission tomography) This scan involves radioactive glucose being injected into a vein in your hand or arm. Using this technology, slow-growing lymphomas can be distinguished from fast-growing ones because of the rate at which the glucose is used by the different cells. […] Bone marrow biopsy A sample of bone marrow is taken, usually from the back of the hip bone, and sent to the laboratory for examination under the microscope. The bone marrow biopsy may be done in the haematologist’s rooms, clinic or day procedure centre and is usually performed under local anaesthesia with sedation given either by tablet or through a small drip in your arm. The sample of bone marrow is examined in the laboratory to determine the number and type of cells present and the amount of haemopoiesis (blood forming) activity taking place there.
  • #2 How We Diagnose Non-Hodgkin Lymphoma | Dana-Farber Cancer Institute
    https://www.dana-farber.org/cancer-care/types/non-hodgkin-lymphoma/diagnosis
    This test looks at genes or chromosomes in cells and tissues. It is used to detect certain chromosomal abnormalities. […] This imaging serves to help determine the disease stage of cancer and to provide a baseline from which to determine your response to treatment. […] This test is used to identify cells, based on the types of antigens or markers on the surface of the cell. This process helps diagnose the specific type of non-Hodgkin lymphoma by comparing the cancer cells to normal cells of the immune system. […] We believe there is great value for patients with suspected or diagnosed non-Hodgkin lymphoma to receive a second opinion. Many times, our pathologists render a different diagnosis from that of the referring doctor. […] Reasons to consider a second opinion include: To confirm your diagnosis. […] To determine the optimal therapy and timing of treatment.
  • #2 Non-Hodgkin Lymphoma: Diagnosis – Stanford Medicine Children’s Health
    https://www.stanfordchildrens.org/en/topic/default?id=non-hodgkin-lymphoma-diagnosis-34-BLymD1
    A pathologist can often see if a person has non-Hodgkin lymphoma by using a microscope to look at the cells taken with the biopsy. But in many cases, other types of lab tests may be needed. […] This information helps the doctor decide on the best treatment plan for you. It also helps give a sense of your likely outcomes (prognosis). […] This test can help show different types of non-Hodgkin lymphoma. […] This is another test that can help tell the type of non-Hodgkin lymphoma. […] Some lymphomas have certain chromosome changes that help classify them. […] These tests may also be used to look for chromosome changes at a more detailed genetic or molecular level. […] FISH can find most chromosome changes that can be seen with standard cytogenetic tests. […] This is a very sensitive DNA test. It can also find some chromosome changes too small to be seen under a microscope. […] Your provider will also talk with you about other tests that may be needed if non-Hodgkin lymphoma is found.
  • #2 Non-Hodgkin Lymphoma: Diagnosis
    https://library.sarahbush.org/wellness/weight/34,BLymD1
    A pathologist can often see if a person has non-Hodgkin lymphoma by using a microscope to look at the cells in the biopsy sample. But in many cases, other types of lab tests may be needed. The tests help to: Make sure the diagnosis is correct. […] Find out the exact type of lymphoma. […] Some lymphomas have certain chromosome changes that help classify them. […] These tests include: FISH (fluorescent in situ hybridization). This test uses special fluorescent dyes that attach to only certain parts of chromosomes. […] It often takes several days or more for the results of your biopsy to come back. When your provider has the results of your biopsy, they will contact you.
  • #2 Lymphoma: Diagnosis and Treatment | AAFP
    https://www.aafp.org/pubs/afp/issues/2020/0101/p34.html
    Lymphoma is a group of malignant neoplasms of lymphocytes with more than 90 subtypes. It is traditionally classified broadly as non-Hodgkin or Hodgkin lymphoma. Approximately 82,000 new U.S. patients are diagnosed with lymphoma annually. […] An open lymph node biopsy is preferred for diagnosis. […] The diagnosis of lymphoma is made using an open lymph node biopsy, based off morphology, immunohistochemistry, and flow cytometry. […] Although fine-needle aspiration and core needle biopsy are often part of the initial evaluation of any adenopathy, neither will provide adequate tissue for the diagnosis of lymphoma because of the need to verify Hodgkin lymphoma via the presence of Reed-Sternberg cells. […] The Ann Arbor staging system was initially developed in 1971 for Hodgkin lymphoma, and was later adapted for non-Hodgkin lymphoma. The Lugano classification system further modified staging by incorporating positron emission tomography/computed tomography (PET-CT) results to determine the staging of the lymphoma.
  • #2 Non-Hodgkin lymphoma | Lymphoma Action
    https://lymphoma-action.org.uk/types-lymphoma/non-hodgkin-lymphoma
    Non-Hodgkin lymphoma affects slightly more males than females. It can develop in people of any ethnic background. […] There are over 60 different types of non-Hodgkin lymphoma. Some of them are very rare. […] Different types of non-Hodgkin lymphoma are often grouped together depending on how they develop or how they behave. […] Non-Hodgkin lymphoma is called high grade when the lymphoma cells are dividing quickly. Specialists can see this when they look at the cells under a microscope. […] High-grade non-Hodgkin lymphoma is sometimes called aggressive lymphoma. Although this might sound alarming, high-grade non-Hodgkin lymphoma usually responds very well to treatment. Most types of high-grade non-Hodgkin lymphoma are unlikely to come back after successful treatment. […] Non-Hodgkin lymphoma is called low grade or indolent when the lymphoma cells are dividing slowly.
  • #2 Non-Hodgkin Lymphoma (NHL) Workup: Approach Considerations, Complete Blood Cell Count, Serum Chemistry Studies
    https://emedicine.medscape.com/article/203399-workup
    The workup in a patient with suspected non-Hodgkin lymphoma (NHL) should include the following: […] Excisional lymph node biopsy is required because lymphoma diagnosis relies heavily on careful assessment of altered nodal architecture accompanying lymphomatous infiltrates. […] In approximately 30-35% of adult patients with NHL, the extranodal sites are the primary presenting sites. The most common site is the GI tract. […] Staging is important in selecting a treatment and determining prognosis. CT scans of the neck, chest, abdomen, and pelvis, as well as bilateral bone marrow aspirate and biopsy, are necessary to stage the lymphoma. […] The Ann Arbor staging system is the most commonly used staging system for patients with NHL. This system divides NHL into 4 stages, as follows: […] In addition to staging, risk stratification is important in patients with NHL. Prospectively validated scoring systems that can be used to determine prognosis include the International Prognostic Index (IPI) for patients with diffuse large B-cell lymphoma and the Follicular Lymphoma International Prognostic Index, (FLIPI) for patients with follicular B-cell lymphomas. The greater the number of risk factors present, the higher the risk.
  • #2 Diagnosis – Non-Hodgkin’s Lymphoma: Diagnosis and Management – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK385274/
    The GC agreed that the benefits of an accurate lymphoma diagnosis outweighed the potential harms because it will ensure the patient enters the correct treatment pathway, but the GC balanced the benefits and harms of the recommendations by allowing for factors specific to an individual patient to guide the choice of diagnostic procedure. […] The GC noted that inadequate sample quality is a frequently occurring problem and presents a major challenge for diagnostic pathologists in confidently diagnosing suspected lymphoma. […] The GC estimated that the recommendations will increase the rate of excision biopsy and the associated costs, but this will be balanced by the decrease in cost associated with fewer diagnostic and non-diagnostic core biopsies and by the reduction in downstream costs associated with more accurate diagnoses.
  • #2 Diagnosis – Non-Hodgkin’s Lymphoma: Diagnosis and Management – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK385274/
    Advanced molecular diagnostics will have a major impact on the diagnosis and stratification of all patients with lymphoma. Although the technologies are the same across lymphoma subtypes the data supporting its routine clinical application is greatest in high grade B-cell lymphomas. […] The GC considered overall survival (OS) to be the critical outcome when drafting the recommendations as OS and progression free survival (PFS) are closely aligned in diffuse large B cell lymphoma (DLBCL) with only a small number of relapsing patients being cured by salvage therapy. […] The GC acknowledged that there would be an impact on surgical resources and uptake would be dependent on availability of surgical services.
  • #2 Non-Hodgkin’s Lymphoma Overview : Diagnosis, types, treatments
    https://thepatientstory.com/patient-stories/non-hodgkin-lymphoma/non-hodgkin-lymphoma-101/
    Staging may involve some of these tests: Bone marrow biopsy: The doctor uses a thick needle to remove a small sample of bone and bone marrow from your hipbone or another large bone. […] CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your head, neck, chest, abdomen, or pelvis. […] Non-Hodgkin lymphoma makes up an estimated 4.3% of all new cancer cases in the U.S. According to the same data, the number of people dying from NHL is going down while the five-year survival rate has been on the rise since 1975. […] According to the National Cancer Institute, there are nine different kinds of standard treatment used for non-Hodgkin’s lymphoma, including: Radiation therapy, Chemotherapy, Immunotherapy, Targeted therapy, Plasmapheresis, Watchful waiting, Antibiotic therapy, Surgery, Stem cell transplant. […] There are also promising new developments in clinical trials and CAR T-cell therapies, especially for refractory/relapsed non-Hodgkin’s lymphoma.
  • #2 Non-Hodgkin Lymphoma Diagnosis | MD Anderson Cancer Center
    https://www.mdanderson.org/cancer-types/non-hodgkin-lymphoma/non-hodgkin-lymphoma-diagnosis.html
    Accurate and precise diagnosis of non-Hodgkin lymphoma helps doctors choose the best course of treatment plans for their patients. It plays a big part in your chances for successful treatment. […] At MD Anderson, our group of experts is among the most experienced and skilled in the nation in diagnosing non-Hodgkin lymphoma. In fact, we are one of the few cancer centers with hematopathologists, specialized doctors who focus on diagnosing lymphoma and other blood cancers, on your care team. With a high level of expertise, they use the most modern equipment to find out the precise extent of disease. This can make a huge difference in accurate diagnosis and successful treatment. […] If you have symptoms that may signal non-Hodgkin lymphoma, your doctor will examine you and ask you questions about your health and your medical history. One or more of the following tests may be used to find out if you have cancer and if it has spread. These tests also may be used to find out if treatment is working.
  • #2 Early Signs of non-Hodgkin Lymphoma | American Cancer Society
    https://www.cancer.org/cancer/types/non-hodgkin-lymphoma/detection-diagnosis-staging/detection.html
    At this time, there are no widely recommended screening tests for non-Hodgkin lymphoma (NHL). Still, in some cases, lymphoma can be found early. […] The best way to find lymphoma early is to pay attention to possible signs and symptoms. […] Careful, regular medical checkups are important for people with known risk factors for NHL (such as HIV infection, having an organ transplant or an autoimmune disease, or prior cancer treatment). These people do not often get lymphoma, but they and their doctors should be aware of possible symptoms and signs of lymphoma.
  • #3 Non-Hodgkin Lymphomas – Hematology and Oncology – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/hematology-and-oncology/lymphomas/non-hodgkin-lymphomas
    Non-Hodgkin lymphomas are a heterogeneous group of disorders involving malignant, monoclonal proliferation of lymphoid cells in lymphoreticular sites, including lymph nodes, bone marrow, the spleen, the liver, and the gastrointestinal tract. […] Diagnosis is usually based on lymph node or bone marrow biopsy or both. […] Non-Hodgkin lymphoma is usually suspected in patients with painless lymphadenopathy. […] Tests needed to make the diagnosis are followed by tests to complete staging and assess etiology and prognosis. […] Enlarged lymph nodes are biopsied. […] Biopsy samples should be reviewed by a pathologist with expertise in lymphoma diagnosis so that the lymphoma can be correctly classified. […] The proper classification of non-Hodgkin lymphoma is critical for treatment planning.
  • #3 Non-Hodgkin lymphoma diagnosis – Leukaemia Foundation
    https://www.leukaemia.org.au/blood-cancer/types-of-blood-cancer/lymphoma/non-hodgkin-lymphoma/diagnosis/
    Non-Hodgkin lymphoma diagnosis […] How is non-Hodgkin lymphoma diagnosed? […] General examination and blood samples At a general examination a doctor will look and feel for any swelling of the glands in your neck, armpits and groin. Your abdomen and chest will also be examined for any signs of enlarged organs or fluid collection. The doctor will also ask you about any other symptoms you might have. At this stage some blood samples may be taken to check how well your bone marrow, liver and kidneys are functioning. Knowing the exact type of lymphoma you have is important because it provides information on the most likely course of your disease and the best way to treat it. […] Biopsy If the doctor suspects that you might have lymphoma, a biopsy will need to be done to help confirm the diagnosis. A biopsy involves removing a lymph node or a sample of tissue from a suspicious lump for examination in the laboratory. There are different types of biopsies. A core or fine needle biopsy involves inserting a needle into a lymph node or lump and removing a sample of tissue. This is usually done under local anaesthetic, while you are awake. If the affected lymph node is deep inside the body the biopsy may be done with the help of ultrasound or specialised x-ray (imaging) guidance.
  • #3
    https://www.nhs.uk/conditions/non-hodgkin-lymphoma/
    The only way to confirm a diagnosis of non-Hodgkin lymphoma is by carrying out a biopsy. […] This is a minor surgical procedure where a sample of affected lymph node tissue is removed and studied in a laboratory.
  • #3 Diagnosis – Non-Hodgkin’s Lymphoma: Diagnosis and Management – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK385274/
    National Guideline Alliance (UK). Non-Hodgkin’s Lymphoma: Diagnosis and Management. London: National Institute for Health and Care Excellence (NICE); 2016 Jul. (NICE Guideline, No. 52.) […] A surgically excised tissue biopsy is widely accepted as the gold standard for the diagnosis of lymphoma based upon the current international guidelines (Lugano 2014 and ESMO 2015). An excision biopsy of a lymph node (or other tissue) allows assessment of micro-architecture, provides adequate material for immunocytochemistry, flow cytometry if received unfixed, FISH studies and extraction of DNA and RNA for molecular diagnostics. Concordance between the results of these investigations provides a high level of confidence in the diagnosis. […] The major disadvantages of an excision biopsy are the need for general anaesthesia and the delays that can result from seeking a surgical opinion.
  • #3 Non-Hodgkin Lymphoma (NHL) Differential Diagnoses
    https://emedicine.medscape.com/article/203399-differential
    A significant number of medical disorders can produce local or generalized lymph node enlargement. Thus, the diagnosis of non-Hodgkin lymphoma (NHL) relies on pathological confirmation following appropriate tissue biopsy. […] If the diagnosis of NHL is doubtful, acquire a second or third opinion from an expert hematopathologist before instituting therapy. Flow cytometry and cytogenetics should also be performed and can be especially helpful in difficult situations.
  • #3 Diagnosis of non-Hodgkin lymphoma | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/non-hodgkin-lymphoma/diagnosis
    A lumbar puncture (also called a spinal tap) removes a small amount of cerebrospinal fluid (CSF) from the space around the spine for examination under a microscope. The sample of CSF will show if NHL is in the brain and spinal cord (called the central nervous system, or CNS). […] Cytogenetics is the analysis of a cell’s chromosomes, including their number, size, shape and arrangement. Cytogenetic techniques show chromosomal abnormalities, which help doctors confirm the diagnosis and identify the type or subtype of NHL. […] Immunophenotyping is the study of proteins expressed by cells. It uses a very specific antigen-antibody reaction to identify proteins in tissues or cells. The fluorescent label and the pattern of proteins that are expressed allow doctors to identify the lymphoma cells so that they can diagnose the specific type or subtype of NHL.
  • #3 How We Diagnose Non-Hodgkin Lymphoma | Dana-Farber Cancer Institute
    https://www.dana-farber.org/cancer-care/types/non-hodgkin-lymphoma/diagnosis
    This test looks at genes or chromosomes in cells and tissues. It is used to detect certain chromosomal abnormalities. […] This imaging serves to help determine the disease stage of cancer and to provide a baseline from which to determine your response to treatment. […] This test is used to identify cells, based on the types of antigens or markers on the surface of the cell. This process helps diagnose the specific type of non-Hodgkin lymphoma by comparing the cancer cells to normal cells of the immune system. […] We believe there is great value for patients with suspected or diagnosed non-Hodgkin lymphoma to receive a second opinion. Many times, our pathologists render a different diagnosis from that of the referring doctor. […] Reasons to consider a second opinion include: To confirm your diagnosis. […] To determine the optimal therapy and timing of treatment.
  • #3 Non-Hodgkin Lymphoma: Diagnosis – Stanford Medicine Children’s Health
    https://www.stanfordchildrens.org/en/topic/default?id=non-hodgkin-lymphoma-diagnosis-34-BLymD1
    A pathologist can often see if a person has non-Hodgkin lymphoma by using a microscope to look at the cells taken with the biopsy. But in many cases, other types of lab tests may be needed. […] This information helps the doctor decide on the best treatment plan for you. It also helps give a sense of your likely outcomes (prognosis). […] This test can help show different types of non-Hodgkin lymphoma. […] This is another test that can help tell the type of non-Hodgkin lymphoma. […] Some lymphomas have certain chromosome changes that help classify them. […] These tests may also be used to look for chromosome changes at a more detailed genetic or molecular level. […] FISH can find most chromosome changes that can be seen with standard cytogenetic tests. […] This is a very sensitive DNA test. It can also find some chromosome changes too small to be seen under a microscope. […] Your provider will also talk with you about other tests that may be needed if non-Hodgkin lymphoma is found.
  • #3 Lymphoma: Diagnosis and Treatment | AAFP
    https://www.aafp.org/pubs/afp/issues/2020/0101/p34.html
    PET-CT is used for fluorodeoxyglucose-avid lymphoma subtypes, with symptoms alone being used for staging the remaining subtypes. […] The new staging system incorporates two symptom-based classifications: A (absence of symptoms) and B (presence of fever, weight loss, and night sweats) for Hodgkin lymphoma. […] A bone marrow biopsy is now recommended only for diffuse large B-cell lymphoma with a negative PET-CT result. […] The International Prognostic Index is used broadly for all subtypes of non-Hodgkin lymphoma, and the International Prognostic Score is used for Hodgkin lymphoma. […] Treatment of lymphoma consists of chemotherapy alone or in combination with radiotherapy. […] Treatment for non-Hodgkin lymphoma varies depending on the histology, but often uses treatments such as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) with or without rituximab (Rituxan; R-CHOP), a monoclonal antibody specific for CD20-positive B lymphocytes.
  • #3 Non-Hodgkin lymphoma | Lymphoma Action
    https://lymphoma-action.org.uk/types-lymphoma/non-hodgkin-lymphoma
    Low-grade lymphomas generally respond well to treatment but they are hard to get rid of completely. They are usually treated with the aim of controlling the lymphoma rather than curing it. […] Most common types of non-Hodgkin lymphoma (all age groups) In adults, the most common types of non-Hodgkin lymphoma are: diffuse large B-cell lymphoma (DLBCL), chronic lymphocytic leukaemia (this is not technically a non-Hodgkin lymphoma but it behaves in a similar way), marginal zone lymphomas (nodal marginal zone lymphoma, extranodal marginal zone lymphoma and splenic marginal zone lymphoma), follicular lymphoma. […] In children and young people, the most common types of non-Hodgkin lymphoma are: Burkitt lymphoma, diffuse large B-cell lymphoma (DLBCL), anaplastic large cell lymphoma (ALCL).
  • #3 Non-Hodgkin Lymphoma | Cancer Support Community
    https://www.cancersupportcommunity.org/non-hodgkin-lymphoma
    Non-Hodgkin lymphoma (NHL) is one of the most common cancers in the United States. […] NHL can be either indolent (slow growing) or aggressive (fast growing). […] To diagnose NHL, your doctor will order several tests, including a physical exam, blood tests, biopsies, and imaging tests. These tests will confirm the exact type and stage of your disease. This will help the doctor decide the best treatment options for you. […] Two kinds of biopsies are used to diagnose NHL: Lymph Node Biopsy and Bone Marrow Biopsy. […] If a biopsy confirms an NHL diagnosis, your doctor may recommend additional tests to find out how far the disease has spread. […] After confirming a NHL diagnosis, the doctor needs to know the stage, or extent, of the disease to plan the best treatment. […] The Ann Arbor Staging System is most commonly used to describe the extent of non-Hodgkin lymphoma in adults. […] Doctors also use the International Prognostic Index (IPI) score to help them better estimate a patient’s outcome. […] The total number of points helps predict the risk of disease relapse.
  • #3 Diagnosis – Non-Hodgkin’s Lymphoma: Diagnosis and Management – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK385274/
    Clinical question: Is core biopsy an acceptable alternative to excision biopsy for the accurate diagnosis of suspected non-Hodgkin’s lymphoma at first presentation? […] Consider an excision biopsy as the first diagnostic procedure for people with suspected non-Hodgkin’s lymphoma at first presentation. […] Genetic and molecular testing has provided important insights into lymphoma biology. When applied to many lymphoma subtypes they have also demonstrated that the diagnosis and subclassification of lymphomas is more accurate when compared with traditional diagnostic methods such as standard microscopy and immunohistochemistry. […] The main problem is that most lymphoma diagnostic technologies are in a phase of rapid change. Data on these newer technologies is limited. […] The GC considered accurate classification of non Hodgkin’s lymphoma (NHL) to be the most important outcome when drafting the recommendations because treatment is crucially dependent on this.
  • #3 https://www.lls.org/lymphoma/non-hodgkin-lymphoma/diagnosis
    https://www.lls.org/lymphoma/non-hodgkin-lymphoma/diagnosis
    An accurate diagnosis is one of the most important aspects of a persons care. A precise diagnosis will help the doctor to […] A biopsy of an involved lymph node or other tumor site is needed to confirm the NHL diagnosis and subtype. […] The purpose of a lymph node biopsy is to: […] Confirm a diagnosis […] Identify your NHL subtype […] Develop a treatment plan. […] NHL is a difficult disease to diagnose, therefore you may want to get a second opinion by an experienced hematopathologist before you begin treatment. The appropriate treatment depends on having the correct diagnosis.
  • #3 Diagnosis – Non-Hodgkin’s Lymphoma: Diagnosis and Management – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK385274/
    Advanced molecular diagnostics will have a major impact on the diagnosis and stratification of all patients with lymphoma. Although the technologies are the same across lymphoma subtypes the data supporting its routine clinical application is greatest in high grade B-cell lymphomas. […] The GC considered overall survival (OS) to be the critical outcome when drafting the recommendations as OS and progression free survival (PFS) are closely aligned in diffuse large B cell lymphoma (DLBCL) with only a small number of relapsing patients being cured by salvage therapy. […] The GC acknowledged that there would be an impact on surgical resources and uptake would be dependent on availability of surgical services.
  • #4 Tests to diagnose non-Hodgkin lymphoma
    https://www.cancerresearchuk.org/about-cancer/non-hodgkin-lymphoma/getting-diagnosed/tests-to-diagnose
    You usually have a number of tests to diagnose non-Hodgkin lymphoma (NHL). If you have NHL, these test results help your doctors find out what type and stage of NHL you have. They also help them decide what treatment you need. […] The main test to diagnose NHL is a lymph node biopsy. A doctor removes part or all of the swollen lymph node. They send it to the laboratory for a specialist to look at it under a microscope. […] The tests you have help your doctor find out if you have lymphoma, what type it is, and where it is in your body.
  • #4 Non-Hodgkin Lymphoma | Cancer Support Community
    https://www.cancersupportcommunity.org/non-hodgkin-lymphoma
    Non-Hodgkin lymphoma (NHL) is one of the most common cancers in the United States. […] NHL can be either indolent (slow growing) or aggressive (fast growing). […] To diagnose NHL, your doctor will order several tests, including a physical exam, blood tests, biopsies, and imaging tests. These tests will confirm the exact type and stage of your disease. This will help the doctor decide the best treatment options for you. […] Two kinds of biopsies are used to diagnose NHL: Lymph Node Biopsy and Bone Marrow Biopsy. […] If a biopsy confirms an NHL diagnosis, your doctor may recommend additional tests to find out how far the disease has spread. […] After confirming a NHL diagnosis, the doctor needs to know the stage, or extent, of the disease to plan the best treatment. […] The Ann Arbor Staging System is most commonly used to describe the extent of non-Hodgkin lymphoma in adults. […] Doctors also use the International Prognostic Index (IPI) score to help them better estimate a patient’s outcome. […] The total number of points helps predict the risk of disease relapse.

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